Improving Patient Care - February 1999 Family Practice Management

February 1999 Table of Contents

Improving Patient Care

A Broader View of Patient Education

By teaching patients about clinical and nonclinical issues, you can replace their uncertainty with trust.

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Brandi White

For family physicians, taking good care of patients today means not only tackling their medical problems but helping patients navigate through the tangled health care system so they can get the care they need. One way to do that is to offer a complete regimen of patient education, one that extends beyond the purely clinical and into the realm of managed care and other "nonclinical" topics.

Case in point

The physicians of Good Hope Family Physicians in Enola, Pa., are believers in patient education of all shapes and sizes. Over the years, two of the physicians, Cathleen Sangillo, MD, and Ernest Josef, MD, have written patient education handouts that their practice uses to help patients understand common clinical problems, such as contact dermatitis, upper respiratory infections and the appropriate use of antibiotics. But the physicians haven't stopped there. They have also created handouts to address nonclinical issues that often cause confusion for patients, such as the importance of primary care, the role of nurse practitioners and the referral process for HMO members (see "A sample handout").

The practice's patient handouts do not take the place of instruction by physicians, nurses or staff, but they are a useful supplement. Often, patients receive a handout when they enter the exam room so they can read it as they wait. The handout might be targeted to the patient's complaint or might simply address a problem area that the physicians have identified within the practice.

Whatever the topic, the handouts play an important role in helping patients become better health care consumers who are informed about their conditions and understand the health care process in general. Ultimately, this makes for more meaningful interactions and can "streamline time spent in the exam room," says Sangillo. "The handouts either cut down on the amount of education we need to provide, or they help the patient to ask more intelligent questions."

A sample handout

This handout can be downloaded in MS Word format.

Good Hope Family Physicians has developed its own patient education handouts to address common clinical problems and nonclinical issues within the practice. Here's a handout on specialty referrals, written by Ernest Josef, MD, based on information the practice gives managed care patients.

Specialty Referrals and Managed Care

If you belong to an HMO, your insurance company may have asked you to choose a "primary care provider" to manage all your health care needs. Family physicians are well-qualified to fulfill this role. We have been trained to provide cradle-to-grave care for you and your family. We diagnose and treat diseases from skin rashes to heart attacks. We are skilled at preventing disease. And we want to build doctor-patient relationships based on mutual trust and respect.

Family physicians can treat 85 to 90 percent of their patients' medical problems. How do we handle the few problems we are unable to treat? We refer patients with those problems to the appropriate specialists.

The referral process

Referrals work pretty much the same for all patients, with one exception: If you are in an HMO, we can generally refer you only to specialists who participate with your HMO. That is, if a physician is not on your HMO's list of "participating providers," your HMO will not pay for visits to that physician. To check, simply call your health plan's customer service line or consult its current provider directory.

We hope you have chosen us as your primary care providers because you trust us to give you quality health care. Part of that trust involves trusting us to decide when to call in a physician who specializes in certain health problems. We refer patients only after we have had a chance to evaluate their conditions. For example, if you had an earache, you would not immediately seek the care of an ear, nose and throat specialist. Instead, you would visit our office so that your family physician could diagnose and treat your earache appropriately. If your case required special treatment, your family physician would then refer you.

Once your family physician has made a referral, our office staff will guide you in setting up an appointment with the specialist your family physician has recommended. When you go to the specialist's office for your first visit, take your referral forms with you. The specialist will then work with your family physician to diagnose and treat your special problems. Once the specialist has completed his or her evaluation or treatment, your family physician will continue your care.

We thank you for your trust in choosing us as your health care providers.

Everybody benefits

The payoff of patient education (whether it addresses asthma care or co-payments) can be substantial. Good patient education doesn't simply create patients who are better informed; it can breed trust and a stronger doctor-patient relationship. Research suggests that when doctors help patients understand their health problems and their care, patients are more satisfied with that care and physicians and are more committed to the health care process.^1-3

Schauffler HH, Rodriguez T, Milstein A. Health education and patient satisfaction. J Fam Pract. 1996;42(1):62-68.
Laine C, Davidoff F, Lewis CE, et al. Important elements of outpatient care: a comparison of patients' and physicians' opinions. Ann Intern Med. 1996;125(8): 640-645.
Robbins JA, Bertakis KD, Helms LJ, et al. The influence of physician practice behaviors on patient satisfaction. Fam Med. 1993; 25(1):17-20.

Brandi White is a senior associate editor of Family Practice Management.

Copyright © 1999 by the American Academy of Family Physicians.
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